Amark P, Nergårdh A
Department of Paediatrics, Karolinska Hospital, Stockholm, Sweden.
Acta Paediatr Scand. 1991 Aug-Sep;80(8-9):824-32. doi: 10.1111/j.1651-2227.1991.tb11956.x.
In children with myelodysplasia and a low lumbar or sacral level of spinal cord lesions detrusor hyperactivity with pressure fluctuations is an almost constant phenomenon contributing to incontinence. In thirteen children with this type of dysfunction the effect of adrenergic agonists and antagonists on bladder and urethral pressures were studied by means of intravesical and urethral pressure recordings during the normal bladder-filling phase. Intravenous infusion of noradrenaline during the bladder-filling phase slightly reduced detrusor hyperactivity and the urethral pressure was increased. Following i.m. injection of the alpha-adrenergic antagonist phentolamine both the intravesical and proximal urethral pressures were reduced to about the same extent and the detrusor hyperactivity decreased. It is concluded that noradrenaline mainly changed urethral pressure while alpha-adrenergic blockade caused decreased tone in both the detrusor and the urethra as well as decreased detrusor hyperactivity.
在患有脊髓发育不良且脊髓损伤位于低位腰椎或骶部水平的儿童中，逼尿肌过度活动伴压力波动是导致尿失禁的几乎恒定的现象。在13名患有此类功能障碍的儿童中，通过在正常膀胱充盈期进行膀胱内和尿道压力记录，研究了肾上腺素能激动剂和拮抗剂对膀胱和尿道压力的影响。在膀胱充盈期静脉输注去甲肾上腺素可略微降低逼尿肌过度活动，同时尿道压力升高。肌内注射α-肾上腺素能拮抗剂酚妥拉明后，膀胱内压和近端尿道压均降低至大致相同程度，逼尿肌过度活动也有所减轻。得出的结论是，去甲肾上腺素主要改变尿道压力，而α-肾上腺素能阻滞导致逼尿肌和尿道的张力降低以及逼尿肌过度活动减少。
